Continue Learning with FreeCME
Clinician.com and FreeCME Account Successfully Created
Your new Clinician account also gives you access to FreeCME, where you can take free accredited for CE credit
LEGAL REVIEW & COMMENTARY
Trial Court’s ‘Confusing’ Instruction Did Not Doom Verdict, Appeals Court Says
July 1, 2025 7 minutes read
By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
A Georgia appellate court has reinstated a defense verdict in a closely watched medical malpractice case arising from complications following a total knee replacement. The case centered on a plaintiff who alleged that a surgeon failed to promptly diagnose and treat a postoperative infection in his left knee. The plaintiff underwent additional surgeries and antibiotic treatment for more than a year after the surgery. He filed suit against the surgeon and the surgeon’s medical practice group in 2020, claiming medical negligence.
The case went to trial in December 2023, but after the jury returned a defense verdict, the trial court granted the plaintiff’s motion for a new trial. The judge cited confusion stemming from her preliminary instruction to the jury on the burden of proof. Although the judge later issued corrected instructions before any evidence was presented, the judge concluded they were insufficient to cure the original error. On appeal, the Georgia Court of Appeals disagreed. In an opinion issued on May 5, 2025, the appellate court held that the trial judge’s correction and clear final instructions adequately addressed any confusion. The appellate court emphasized that juries are presumed to follow the law as instructed, and it found no basis to disturb the defense verdict.
This case highlights the critical role jury instructions play in trial outcomes. It also highlights the importance of judicial flexibility and the appellate court’s role in ensuring fairness without punishing honest mistakes that get corrected in time.
Background
In April 2018, the plaintiff sought medical care from an orthopedic surgeon to address issues in his left knee. The surgeon recommended a total knee replacement, which was performed the next month. In the weeks following surgery, the plaintiff developed an infection in his repaired knee. Over the next year and a half, he had multiple follow-up surgeries, including procedures on the knee and his left quadriceps as well as repeated courses of antibiotics to try to resolve the infection.
On Aug. 25, 2020, the plaintiff filed a medical malpractice lawsuit against the surgeon and his employer. He alleged that the surgeon failed to promptly diagnose and treat the infection. The case went to trial in December 2023.
At the outset of the trial, after jury selection, the trial court provided the jury with preliminary instructions. These included an explanation of the burden of proof in civil cases. Specifically, the court stated that while jurors might be familiar with the concept of proof beyond a reasonable doubt from criminal cases, that standard did not apply in civil matters. However, the court then stated that if the jury had “any doubt” as to where the preponderance of the evidence lay, it was their duty to resolve the issue against the party with the burden of proof. The plaintiff’s counsel objected, arguing that the instruction improperly conflated the civil burden of proof with the criminal standard, which could prejudice the jury against the plaintiff.
Although the trial judge initially overruled the objection, the judge revisited the issue following opening statements. Acknowledging that the earlier instruction on the burden of proof may have been “very confusing,” the judge issued a clarifying recharge. The judge explained to the jury that in civil cases, a party meets the burden of proof if the evidence shows a fact is more likely true than not. Neither party objected to the revised instruction.
Later, after the close of evidence, the court again proposed to use the simplified explanation. The parties and court discussed recent appellate authority disapproving the outdated pattern charge. The court ultimately adopted the simplified instruction, which it delivered to the jury before deliberations, along with a written copy of the jury charge.
The jury returned a defense verdict in favor of the defendant and his employer. The plaintiff then moved for a new trial, arguing that the original preliminary instruction remained prejudicial and that the recharge failed to cure the confusion. In May 2024, the trial court granted the motion, agreeing that the initial instruction on burden of proof was erroneous and that the corrective instructions had not sufficiently mitigated the impact.
The defendants appealed. In a unanimous opinion issued on May 5, 2025, the Georgia Court of Appeals reversed the trial court’s grant of a new trial. The appellate court held that, although the preliminary instruction was flawed, the trial court clearly acknowledged the error, addressed it in a timely manner before any evidence was presented, and also reinforced the correct standard during the final jury instructions. The appellate court emphasized that juries are presumed to follow a court’s instructions and found no evidence that the jury had been misled or prejudiced. Accordingly, the appellate court reinstated the defense verdict, concluding that the trial was fair and the jury was properly instructed on the law.
What This Means for You
The recent appellate ruling in this Georgia medical malpractice case highlights how a trial can turn not just on the facts, but also on the legal instructions given to the jury. The process of crafting jury instructions, and ensuring they are legally correct and clearly understood, is a critical part of any trial.
When a jury is selected to hear a civil case, such as a medical malpractice claim, they are responsible for deciding the facts, such as what happened, who is responsible, and how much, if anything, should be awarded in damages. The judge provides them with legal instructions to guide their deliberations. These instructions explain legal concepts the jury must apply, such as the burden of proof, the elements of each claim, and what standards must be met to find liability.
Jury instructions are important in shaping how jurors evaluate the evidence, and plaintiffs and defendants may spend significant time during trial arguing over exactly how the instructions should be worded. Judges rely on model or “pattern” jury instructions that are meant to reflect established law, but these models are not always up to date or appropriate for every case.
One of the most important instructions in any civil case is the one explaining the burden of proof. In criminal cases, the prosecution must prove the defendant’s guilt “beyond a reasonable doubt,” which is a high standard. But in civil cases, such as this medical malpractice case, the plaintiff only needs to prove their case “by a preponderance of the evidence.” This means that the plaintiff must show that it is more likely than not that the defendant did something wrong. If the scales tip ever so slightly in the plaintiff’s favor, even 51% to 49%, then the plaintiff has met the burden. It is a lower bar than the criminal standard, and it reflects the different stakes because civil cases usually involve money rather than potential prison time.
Courts also may take time to explain that the civil burden is not “beyond a reasonable doubt.” In doing so, the judge must not blur the line between the criminal and civil standards or suggest that any doubt must be resolved against the plaintiff. Here, at the start of the trial, the judge gave a preliminary instruction explaining the preponderance standard, but did so in a way that seemed to imply jurors should decide against the plaintiff if they had “any doubt.” The plaintiff’s attorney objected, arguing that this misstated the law. The judge ultimately reconsidered that instruction and gave the jury a corrected version. After the evidence was presented, the judge again used the corrected language in her final instructions and even provided the jurors with a written copy. The jury ultimately found in favor of the defense.
Despite the favorable verdict, the judge later granted the plaintiff a new trial, saying she believed her initial mistake might have unfairly influenced the jury. The defendants appealed, and the Georgia Court of Appeals reversed that decision, reinstating the original verdict.
The appellate court’s ruling highlights how the legal system balances the need to correct mistakes against the goal of finality in litigation. When reviewing jury instruction errors, appellate courts look at the instructions as a whole and consider whether the instructions, taken together, accurately informed the jury of the law. Appellate courts are guided by two key principles: first, that trial judges are allowed to fix their own mistakes during the trial, and second, that juries are presumed to follow the instructions they are given.
In other words, a mistake in the initial instructions is not automatically grounds for a new trial, especially if the judge acknowledges the problem and corrects it. Here, the appellate court found that the judge not only corrected the error, but did so before the jury heard any evidence. The jurors received a clear and accurate explanation of the legal standard they were supposed to apply, both during trial and again before deliberations. As a result, the court concluded there was no reason to believe the jury had been misled or that the plaintiff was unfairly prejudiced.
The concept of “prejudice” means more than just showing that something went wrong during the trial. It requires showing that the mistake likely affected the outcome. Appellate courts recognize that no trial is perfect and that small errors happen all the time. But unless a party can show that the error had a real effect on the verdict, the result usually will stand.
In this case, while the judge admitted her initial instruction was confusing, the plaintiff could not show that the confusion lingered or changed the way the jury decided the case. The appellate court emphasized that legal errors must be evaluated in the context of the entire trial record. The system is designed to allow judges to clarify and correct errors on the spot.
The case reinforces the principle that courts generally will not overturn a jury verdict unless there is concrete evidence that an error, such as an improper instruction, actually affected the outcome. Ultimately, the decision is a vote of confidence in the idea that juries, when properly instructed, can fairly evaluate the facts and reach just results, even if there are minor errors along the way.
Reference
- Decided on May 5, 2025, in the Court of Appeals of Georgia, Case No. A25A0004.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles
Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
A Georgia appellate court has reinstated a defense verdict in a closely watched medical malpractice case arising from complications following a total knee replacement. The case centered on a plaintiff who alleged that a surgeon failed to promptly diagnose and treat a postoperative infection in his left knee.
Article Limit Reached
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content